Health Tips for the Facial Feminisation Patient

January 26, 2011

There is an unending list of questions about how to prepare for surgery, what to do for each procedure (or more importantly NOT DO) and how to best care for yourself in the year as the majority of healing occurs. This is why we have an entire volume of videos dedicated to the theme on our YouTube channel.

In this post we have also compiled some of the most frequently answered questions with answers, as per the doctor’s orders. As your situation may be different, always speak with your surgical team for specific instructions in your case.

Health

Please notify us of any health conditions and medications you take, which will be kept confidential. HRT does not need to be suspended before surgery since we will administer an anti-thrombotic medication to counteract the clotting effects of hormones.

Smoking

As smoking counteracts the healing of wound, we strongly recommend not smoking 3 weeks before and after surgery.

Swelling and bruising

We utilize a special cooling mask, placed immediately after surgery and used almost constantly for the first 24 hours. This mask keeps the surface tissues at the optimum temperature to reduce swelling, bruising and alleviate discomfort due to the operation. Thereafter, follow our directions for cooling and the use of compression bandages. Bruising and swelling will peak 2-3 days following surgery and will subside about 7-10 days later. Some swelling may be evident for several weeks after surgery; especially following augmentation or bone reconstruction surgery. However, any residual swelling lasting more than a month is minimal and not noticeable to others.

Emotions

The first days following surgery you are swollen, bruised, and sore – both physically and mentally. A professional service is available upon request, offering psychological support by phone and email. We also recommend pre-op treatment to assist with transition.

Lumps and Scabs

Tightness, hardness and lumpiness around the face, jaw, and neck is common and will subside over time. After one week, gentle massaging with Thrombocid Forte cream can be applied to any lumpy areas to aid the tissue recuperation. Do not pick or remove any scabs or crusting.

Pain

The pain is surprisingly moderate with facial feminization. Most patients will experience discomfort more than pain, which is usually perfectly controlled with normal painkillers. However, if you continue to experience pain, you should inform us. Pain medication is generally not needed after one week.

Numbness

A total or partial lack of feeling near the treated area is normal and will gradually improve with time, usually between 3 – 6 months. This may take up to one year in some cases.

Bleeding

You may experience light bleeding in or around the incision areas, which is not a problem. However, it you find any large and/or hard collections of blood or excessive bleeding please alert our office immediately. If you have any new areas of fluid collections contact us as soon as possible. According to the situation, we will advise as to what you should do and arrange to treat the area.

Medications

We will provide you with a post-op medication packet with antibiotics and painkillers, modified according to patient needs. Other complementary medicines or ointments will also be recommended. We suggest you consult with your physician before stopping or resuming any discontinued medications.

Cleaning external incision

We will see you routinely for wound care in the clinic. However, if you need to clean the incision areas in the hotel, keep these instructions on hand:

If you have or a bandage or sterile strips that cover the wound, do not touch it and keep it dry. Otherwise, use a gentle cleanser for your face such as Cetaphil. With clean hands, softly massage in a tiny amount of cleanser, avoiding incisions. Rinse your face as normal with cool water and gently dab dry with a clean cloth. Allow to air dry completely or use a hairdryer on a cool setting. Any remaining moisture should be removed by dabbing with sterile gauze moistened with alcohol 60% (avoid eyes, nose and mouth). When thoroughly dry, you may opt to use an antibacterial ointment to keep incisions clean and flexible—encouraging the incisions to heal quickly. Never pull the skin! Keeping the incision areas as clean as possible will also help us remove your sutures more easily.

Scars

Along the hairline, hairs will eventually grow through the incision, partially hiding it. Our surgeons have developed incision and suture techniques entirely new in the repositioning of the hairline, minimizing the scar size and visibility. As the incision is just inside the hairline and the movement of the scalp is on a layer much deeper than the hair roots, you should not lose hair. Any hair loss is, generally speaking, mild and temporary. You may begin massaging scars 3 weeks after surgery with Dermatix gel, daily for one year to flatten and minimize the visibility.

Personal Hygiene

You may shower 24 hours following surgery. Baths are acceptable, if short and not too hot; but avoid soaking any of the treated areas in water. Your incisions can get wet but should not be soaked for long periods of time. A mild, pH neutral baby shampoo is best. Do not bend over to wash your hair, instead, hold your head back in the shower if you can. When washing your hair, always gently massage towards your incisions – never away. Be gentle with your face and scalp—especially when towelling dry and do not apply strong pressure to the scalp. Only use a hair dryer on the low, cool setting until 8 weeks after surgery.

Movement & Food

At the hospital once the catheter is removed, you may try to get up gently and eventually take short slow walks in the hallway, unless the doctor indicates the contrary. During the first week after surgery you should rest as much as possible. However, it is good to take short, gentle daily walks when you feel better. You also should avoid bending over at the waist for the first few days after surgery. Instead, bend at the knees and/or turn your entire body if necessary. Keep your head elevated at all times. Avoid moving your head around too much, as well as excessive chewing by consuming soft foods like fruit shakes, yogurt, soup, eggs, and pudding following surgery. Minimize your facial movements (i.e. talking, turning your head) as much as possible to allow the skin and tissue to heal properly. With forehead reconstructions, sneezing and nose blowing should be avoided for 10 days.

Eating

An empty stomach is required for surgery and you will not be permitted to eat initially. The first 24 hours post-op, you will be on a liquid diet. Thereafter, you may slowly resume soft foods, as directed. We recommend a high-calorie shake to ensure you get the nutrition you need while you are not able to eat properly.

Sleeping

When sleeping, use two pillows to prop up your head and support your neck, trying to keeping your head slightly higher than your heart. Do not sleep on your side for one week and if necessary, place pillows laterally to prohibit yourself from turning over while sleeping.

Work & Play

We highly recommend total rest and relaxation for two full weeks following surgery. Providing your body ample time to recover, with physical and mental relaxation, will help you heal faster in the long run! A positive outlook is also scientifically proven to aid in healing…practice your new smile!

Physical activity that raises your blood pressure or causes sweating should be resumed with caution, slowly, after 6 weeks. Travelling is permitted after one week, but ask for help with any heavy luggage. After two weeks you may resume: high-demand driving, sedentary work, and light exercise like slow walking. Intense exercise (i.e. running, Pilates) may be resumed 6 weeks following surgery, depending on your recovery. Yoga, especially upside-down poses, should be avoided for 8-10 weeks. Ask us if you plan to do any high impact or full contact sport soon.

Beauty

Do not use hot hair rollers or get your hair cut, permed or colored for six weeks. You can apply light makeup gently after 1 week. Take care with heavy ear jewellery. Strong anti-ageing skin treatments should be avoided for 3 months. Electrolysis may be resumed after 6 weeks.

Sun

Avoid sun exposure to the surgical area for six weeks and use sunscreen, even on cloudy days on incisions for at least one year. This will help improve the quality of the scar and help it fade over time. Sun exposure causes skin damage which leads to early signs of aging.

Support

Our team of coordinators will take care of you from the first contact. They help with many logistical details such as accommodation and organizing appointments as well as airport transfers. They will provide you with a mobile phone so you may reach them at the touch of a button 24 hours a day. Be it with our dedicated nurses or staff psychologist, we look after your wellbeing in many ways, with even lymphatic massage, acupuncture, group sessions, and more. You may rely on our postop department to follow up by email once you return home, attending to your worries for months after surgery.